Rheumatoid arthritis (RA) is a major cause of morbidity and disability in the U.S. population, with a higher prevalence in some American Indian and Alaska Native tribes. In this chronic illness, early identification and treatment of disease lead to improved long-term outcomes. Treatment guidelines exist for RA, stressing the importance of early, aggressive treatment with frequent reassessments. High-quality care for RA can substantially impact the disease course. Recently, the Arthritis Foundation developed a set of 27 quality indicators for the care of RA. The aims of this pilot project are to: 1) perform retrospective medical record review to determine the frequency of compliance with 8 of the Arthritis Foundation's 27 quality indicators for RA for Alaska Natives residing in the Anchorage Service Unit; 2) gather information on patient and provider characteristics that may influence quality of care; and 3) use the information from this pilot study to generate hypotheses for further studies of quality of care for RA in Alaska Natives and to develop quality improvement initiatives. The long-term goals of these studies are to determine what deficiencies are present in RA care, to determine factors contributing to these deficiencies, and to develop quality improvement initiatives to be implemented statewide to improve the care of Alaska Natives with RA. Relevance: Rheumatoid arthritis is a chronic condition that can lead to joint deformities and loss of function over time. If the arthritis is properly treated, the risk of long-term consequences from rheumatoid arthritis is reduced. This study is relevant to public health because we are measuring the quality of care provided for Alaska Natives with rheumatoid arthritis, with the ultimate goal of improving the quality of care that Alaska Natives receive for rheumatoid arthritis. [unreadable] [unreadable]